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Dermbits

How has topical roflumilast simplified the way you consult patients with plaque psoriasis? 

Psoriasis

You. I think that for psoriasis patients who are more mild to moderate disease, I think this can be tricky, because many times, if they have a lot of body surface area, that topical medicines aren't going to be an option. Well, we're going to jump right to a systemic therapy. But for those patients that have more localized disease that really want to stay with topical options and maybe aren't eager to go to the bigger guns, the systemic agents, it's tricky. We only have a couple of things in our toolbox, and one of those is topical corticosteroids, which essentially 100% of my patients have used or are using, but they're not the panacea. And part of the problem with topical corticosteroids is that people can overuse them and damage the skin. So I'm really excited to have a once daily non steroidal agent that we can use, even in intratrogenous areas and delicate skin. And I love the fact that I can use my steroid to get things calm, use it if we have a bad flare up, but then we can use a non steroidal agent to help maintain, not only is it once daily, which makes it really nice, it's very, very nice vehicle. It's cosmetically elegant. And what I love about it is the safety profile is extremely reassuring. So what I'm hearing back from patients is that this is sort of what they've been looking for, that they have long needed something else in that toolbox so that they could not always rely on topical steroids or be told that they have to go on a systemic agent like a biologic. And arguably, this isn't maybe that many patients. There's a lot of patients who are comfortable doing both of those things, but it's a sizable group of people. And what I love is that as I get more experience with it and I get more positive feedback, well, that's a virtuous cycle. That's a positive feedback loop, because then the next patient comes in and says, is there anything else besides triumphsinolone? I can say, yes, there is. We have a couple of new things, things to try, and this is one that I really like. Why don't you see how this feels? Why don't we try this out? And I love being able to give people options, because the hardest part for me is that not everybody is the same. There is really no one size fits all. And it's very frustrating when you have one dominant drug or one class, and it's sort of, well, this is a standard of care. Yes, it is. It's a great place to start. But what about for all the people for whom it's not a good fit? And that's why I'm so grateful to have new tools.